title: Diffuse ST-elevation following J-wave presentation as an uncommon electrocardiogram pattern of Tako-Tsubo cardiomyopathy.
abstract: BACKGROUND
  Tako-Tsubo cardiomyopathy (TTC) is characterized by symptoms, ECG changes with elevated cardiac markers mimicking acute myocardial infarction, left ventricular (LV) wall motion abnormalities in the apical region with preserved function of base, and normal coronary arteries. Usual ECG anomalies heralding TTC are ST-elevation in anterior leads, QT prolongation and negative T-waves.
  
  
  METHODS
  We report the unusual case of TTC with an uncommon ECG presentation: J wave in inferior leads followed by diffuse ST-elevation.
  
  
  RESULTS
  An 82-year-old woman was admitted for dyspnea and chest pain following exacerbation of chronic obstructive pulmonary disease. ECG showed J-wave in inferior leads followed by diffuse ST-elevation. The patient was monitored in intensive care unit and treated with diuretics. Both ECG and echocardiography anomalies gradually recovered.
  
  
  CONCLUSIONS
  Diffuse ST-elevation following J-waves may be considered as a possible ECG pattern of presentation in case of TTC.
authors.affiliation: Department of Cardiology, University of Foggia, Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Santoro
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ieva
authors.forename: Armando
authors.initials: A
authors.lastname: Ferraretti
authors.forename: Luisa
authors.initials: L
authors.lastname: De Gennaro
authors.forename: Lodispoto
authors.initials: L
authors.lastname: Michele
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.forename: Natale Daniele
authors.initials: ND
authors.lastname: Brunetti
mesh_terms: D000369:Aged, 80 and over; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D018618:Echocardiography, Doppler, Color; D004562:Electrocardiography; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000503:physiopathology
keywords: Chronic obstructive pulmonary disease; Diffuse ST-elevation; Electrocardiogram; J-wave; Tako-Tsubo cardiomyopathy